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饮食失调的人际心理治疗:当前观点

Interpersonal psychotherapy for eating disorders: current perspectives.

作者信息

Miniati Mario, Callari Antonio, Maglio Alessandra, Calugi Simona

机构信息

Department of Clinical and Experimental Medicine, Section of Psychiatry, University of Pisa, Pisa, Italy,

Department of Eating and Weight Disorders, Villa Garda Hospital, Verona, Italy.

出版信息

Psychol Res Behav Manag. 2018 Sep 5;11:353-369. doi: 10.2147/PRBM.S120584. eCollection 2018.

Abstract

BACKGROUND

Interpersonal psychotherapy (IPT) is a time-limited and affect-, life-event-, and present-focused psychotherapy originally conceptualized for unipolar depression, and then adapted to the treatment of other disorders, including eating disorders (EDs). The purpose of this paper is to conduct a systematic review of studies on IPT for EDs.

METHODS

The authors performed literature searches, study selection, method, and quality evaluation independently. Data were summarized using a narrative approach.

RESULTS

Of the 534 papers retrieved, 37 studies met the inclusion criteria, and 15 were considered for the systematic review (randomized controlled trials and long-term follow-up studies derived from the randomized controlled trials). Their analysis revealed six main findings: 1) no significant differences between IPT and cognitive-behavioral therapy (CBT) were found when administered as monotherapy to patients with anorexia nervosa; 2) when administered as monotherapy to patients with bulimia nervosa (BN), IPT had lower outcomes than CBT and its enhanced version; 3) patients with BN who remitted with IPT showed a prolonged time spent in clinical remission, when followed up on the long term; 4) IPT and CBT, with different timings and methods, have both shown efficacy in the mid-term/long-term period in patients with BN; 5) CBT and its enhanced version produced rapid changes in the acute phase. IPT led to improvements occurring later, with slower changes that tended to maintain efficacy in the long term; 6) abstinence from binge eating with group IPT for binge eating disorder is stable and maintained (or further improved) in the long term.

CONCLUSION

IPT is a reasonable, cost-effective alternative to CBT for the overall ED spectrum.

摘要

背景

人际心理治疗(IPT)是一种限时的、以情感、生活事件和当下为重点的心理治疗方法,最初是为单相抑郁症而设计,随后被应用于包括饮食失调(EDs)在内的其他疾病的治疗。本文旨在对有关IPT治疗EDs的研究进行系统综述。

方法

作者独立进行文献检索、研究筛选、方法和质量评估。采用叙述性方法对数据进行总结。

结果

在检索到的534篇论文中,37项研究符合纳入标准,15项被纳入系统综述(随机对照试验以及源自随机对照试验的长期随访研究)。他们的分析得出了六个主要发现:1)在对神经性厌食症患者进行单一疗法治疗时,未发现IPT与认知行为疗法(CBT)之间存在显著差异;2)在对神经性贪食症(BN)患者进行单一疗法治疗时,IPT的效果低于CBT及其强化版本;3)接受IPT治疗后缓解的BN患者在长期随访中临床缓解时间延长;4)IPT和CBT在不同的时间安排和方法下,对BN患者的中期/长期疗效均已得到证实;5)CBT及其强化版本在急性期产生快速变化。IPT导致的改善出现较晚,变化较慢,但长期疗效趋于维持;6)团体IPT治疗暴饮暴食症后,暴饮暴食行为的戒除在长期内稳定且得以维持(或进一步改善)。

结论

对于整个饮食失调谱系,IPT是一种合理且具有成本效益的CBT替代方法。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/e878/6130260/708abac966b6/prbm-11-353Fig1.jpg

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